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Wondering What’s Happening with Telehealth Legislation in Ohio?

Introduction

In December 2021, Governor DeWine signed into law HB 122, which will expand telehealth services in Ohio. The law takes effect in March 2022 and is in response to more patients relying on telehealth over the past two years during the height of the COVID pandemic, and more providers becoming comfortable with delivering services virtually. Telehealth is now a normalized healthcare delivery system nationwide. Beyond the safety benefits inherent in telehealth services, telehealth has made healthcare more accessible and more affordable for more people.

HB 122 At a Glance

HB 122 broadly expands the list of providers who can bill for telehealth services and replaces outdated regulations that limited access to telehealth care. Before HB 122, only physicians, physician assistants and advanced practice registered nurses could provide services via telehealth. HB 122 expands telemedicine use to include psychologists, speech and hearing therapists, physical therapists, counselors and social workers, dietitians, optometrists, chiropractors and several other health care specialties.[1] The law also removes the requirement that a patient’s initial visit be in-person and instead allows initial and annual patient visits to be conducted virtually.  

HB 122 requires both public (i.e., Medicaid and Medicare) and private insurance to cover telehealth services. Additionally, the law prohibits health plans from imposing cost sharing for telehealth services that exceeds the cost sharing for equivalent in-person services. 

Finally, HB 122 applies to more regulated treatment modalities. The law will allow physicians authorized to prescribe medical marijuana to conduct the required in-person patient exams via telehealth. While most patients that are prescribed a schedule II controlled substances are required to still attend their initial visit in-person, HB 122 sets forth several exceptions that allow for an initial visit via telehealth, including if 1) the patient is in palliative or hospice care; 2) the patient receives medication-assisted treatment for opioid use disorder; 3) the patient is currently under treatment for a diagnosed mental health condition; or 4) the patient is treated in an emergency situation. 

To ensure compliance with the new state telehealth laws, please contact Kevin Cripe at kmcripe@bmdllc.com, 614.246.7506, or your existing BMD healthcare attorney.

[1] The full list of allowed providers is: Advanced practice registered nurses; Optometrists licensed to practice under a therapeutic pharmaceutical agents certificate; Pharmacists; Physician assistants; Physicians; Psychologists and school psychologists, including school psychologists licensed under State Board of Education rules; Chiropractors; Audiologists and speech-language pathologists; Occupational therapists and physical therapists; Occupational therapy assistants and physical therapist assistants; Professional clinical counselors, independent social workers, and independent marriage and family therapists; Independent chemical dependency counselors; Certified Ohio behavior analysts; Dietitians; Respiratory care professionals; and Genetic counselors.

Explosive Growth in Pot of Gold Opportunity for Bank (and Other) Cannabis Lenders Driving Erosion of the Barriers

Our original article on bank lending to the cannabis industry anticipated that the convergence of interest between banks and the cannabis industry would draw more and larger banks to the industry. Banks were awash in liquidity with limited deployment options, while bankable cannabis businesses had rapidly growing needs for more and lower cost credit. Since then, the pot of gold opportunity for banks to lend into the cannabis industry has grown exponentially due to a combination of market constraints on equity causing a dramatic shift to debt and the ever-increasing capital needs of one of the country’s fastest growing industries. At the same time, hurdles to entry of new banks are being systematically cleared as the yellow brick road to the cannabis industry’s access to the financial markets is being paved, brick by brick, by the progressively increasing number and size of banks that are now entering the market.

2021 EEOC Charge Statistics: Retaliation & Impact of Remote Work

The U.S. Equal Employment Opportunity Commission (EEOC) released its detailed information on workplace discrimination charges it received in 2021. Unsurprisingly, for the second year in a row, the total number of charges decreased as COVID-19 either shut down workplaces or disconnected employees from each other. In 2021, the agency received a total of approximately 61,000 workplace discrimination charges - the fewest in 25 years by a wide margin. For reference, the agency received over 67,000 charges in 2020, and averaged almost 90,000 charges per year over the previous 10 years.

Ohio’s Managed Care Overhaul Delayed – New Implementation Timeline

At the direction of Governor Mike DeWine, the Ohio Department of Medicaid (ODM) launched the Medicaid Managed Care Procurement process in 2019. ODM’s stated vision for the procurement was to focus on people and not just the business of managed care. This is the first structural change to Ohio’s managed care system since the Centers for Medicare & Medicaid Services' (CMS) approval of Ohio’s Medicaid program in 2005. Initially, all of the new managed care programs were supposed to be implemented starting on July 1, 2022. However, ODM Director Maureen Corcoran recently confirmed that this date will be pushed back for several managed care-related programs.

Laboratory Specimen Collection Arrangements with Contract Hospitals - OIG Advisory Opinion 22-09

On April 28, 2022, the Department of Health and Human Services, Office of Inspector General (“OIG”) published an Advisory Opinion[1] in which it evaluated a proposed arrangement where a network of clinical laboratories (the “Requestor”) would compensate hospitals (each a “Contract Hospital”) for specimen collection, processing, and handling services (“Collection Services”) for laboratory tests furnished by the Requestor (the “Proposed Arrangement”). The OIG concluded that the Proposed Arrangement would generate prohibited remuneration under the federal Anti-Kickback Statute (“AKS”) if the requisite intent were present. This is due to both the possibility that the proposed per-patient-encounter fee would be used to induce or reward referrals to Requestor and the associated risk of improperly steering patients to Requestor.

Property Owner Protection from Tax Valuation Challenges

New legislation provides significant new protections for commercial property owners against challenges to valuation primarily by local school boards and prohibiting side agreements to avoid tax valuation changes. The Ohio Legislature has approved House Bill 126 which will go into effect July 2022 but will effectively apply to the 2023 tax valuation year.